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Objective:To investigate the efficacy and adverse reactions of concurrent chemoradiotherapy (CRT) and radiotherapy (RT) alone in the treatment of cervical cancer patients with intermediate-risk factors after operation.Methods:The clinical data of 210 patients with cervical cancer patients after operation in Shanxi Province Cancer Hospital between August 2014 to March 2016 were retrospectively analyzed. The postoperative pathology met the Sedlis standard. All patients were divided into RT alone group (100 cases) and CRT group (110 cases) according to the different adjuvant treatment regimens; and the efficacy and adverse reactions of both groups were also analyzed.Results:The 3-year progression-free survival (PFS) rate was 82.8%, 81.5%, respectively in RT alone group and CRT group ; 5-year PFS rate was 80.6%, 77.4%, respectively in RT alone group and CRT group; and there were no statistically significant differences in the PFS of both groups ( χ2 = 0.29, P = 0.591). The 3-year overall survival (OS) rate was 88.5%, 86.7%, respectively in RT alone group and CRT group; 5-year OS rate was 86.4%,82.6%, respectively in RT alone group and CRT group; and there were no statistically significant differences in the OS of both groups ( χ2 = 0.59, P = 0.443). The local recurrence rate was 8.0% (8/100) and 9.1% (10/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.08, P = 0.778); the distant metastasis rate was 11.0% (11/100) and 12.7% (14/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.15, P = 0.699); the incidence of bone marrow suppression was 42.0% (42 /100) and 61.8% (68/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 8.25, P < 0.01). The incidence of gastrointestinal reactions was 23.0% (23/100) and 77.3% (85/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 49.94, P < 0.01);the incidence of radiation cystitis was 3.0% (3/100) and 3.6% (4/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.06, P = 0.798). The incidence of radiation proctitis was 5.0 %(5/100) and 4.5% (5/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.02, P = 0.877). Conclusions:For cervical cancer patients with intermediate-risk factors, CRT shows no survival benefit and increases the incidence of adverse reactions compared with RT alone.
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Objective:To investigate the relationship between tumor volume changes, squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and the prognosis of cervical cancer patients with concurrent radiotherapy and chemotherapy and their combined prediction of prognosis.Methods:One hundred and twenty-eight patients in Shanxi Cancer Hospital from February 2018 to February 2020, with cervical cancer undergoing radical concurrent radiotherapy and chemotherapy were selected for a prospective study. According to different prognostic effects, the patients were divided into poor prognosis group (44 cases) and good prognosis group (84 cases). The general data, tumor reduction rate (TVRR), SCC-Ag, CEA, and CA125 levels were compared between the two groups, and the Logistic regression equation was used to analyze the prognostic factors of patients with concurrent radiotherapy and chemotherapy for cervical cancer. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to analyze the performance of each index and the joint prediction of prognosis. Kaplan-Meier survival curve analysis and log-rank (Mantel-Cox) were used to test the survival curves of TVRR, SCC-Ag, CEA, CA125 high-risk individuals and low-risk individuals.Results:The TVRR in the poor prognosis group was significantly lower than that in the good prognosis group: (76.63 ± 7.52)% vs. (85.54 ± 6.71)%, the SCC-Ag, CEA, CA125 were significantly higher than those in the good prognosis group: (6.98 ± 2.15) μg/L vs. (4.61 ± 1.37) μg/L, (9.34 ± 2.23) μg/L vs. (5.76 ± 1.87) μg/L, (68.79 ± 12.01) kU/L vs. (49.97 ± 15.22) kU/L, and there were statistical differences ( P<0.05). Logistic regression showed that TVRR, SCC-Ag, CEA and CA125 were significant factors influencing the prognosis of patients with concurrent chemoradiotherapy for cervical cancer ( P<0.05). Among the single indicators, TVRR predicted the highest prognosis AUC, and the combined prognostic AUC of all indicators (0.837, 95% CI 0.761 to 0.920) was higher than any single indicator, with a sensitivity of 81.82% and specificity of 84.52%. The survival curves of TVRR, SCC-Ag, CEA, CA125 between high-risk and low-risk patients showed statistically significant differences ( P<0.05). Conclusions:The changes in tumor volume, SCC-Ag, CEA, CA125 and the prognosis of patients with concurrent radiotherapy and chemotherapy for cervical cancer have a certain correlation. The combined examination of the four in the early stage is expected to become a new approach to clinically predict the prognosis of cervical cancer and make appropriate treatment plans.
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Objective:To analyze the clinical effect, adverse events and prognosis of microwave hyperthermia combined with radiotherapy in the treatment of patients with advanced gastric cancer.Methods:From May 2017 to May 2019, 80 patients with advanced gastric cancer admitted to Cancer Hospital of Shanxi Province were selected and divided into two groups according to the random digital table method, with 40 cases in each group.The control group was treated with radiotherapy, and the study group was treated with microwave hyperthermia on the basis of the control group.The clinical efficacy, adverse events and prognosis of the two groups were compared.Results:The total effective rate in the study group was 90.00%(36/40), which was higher than 70.00%(28/40) in the control group (χ 2=5.000, P<0.05). After treatment, the diameter of tumor in the study group was lower than that in the control group[(2.30±0.20)cm vs.(2.66±0.23)cm, t=7.470, P<0.05]. The incidence of adverse events in the study group was 10.00%(4/40), which was lower than 27.50%(11/40) in the control group(χ 2=4.020, P<0.05). The quality of life scores of the study group[physiological function (74.17±5.23)points, physical pain (73.07±5.49)points, general health (75.13±5.50)points, mental state (75.16±3.27)points and social function (75.49±3.24)points] were better than those of the control group[(62.55±5.70)points, (63.24±6.37)points, (65.72±5.30)points, (63.05±2.49)points, (65.34±4.59)points]( t=9.500, 7.393, 7.791, 18.634, 11.425, all P<0.05). Conclusion:Microwave hyperthermia combined with radiotherapy can reduce adverse events and improve the quality of life of patients with advanced gastric cancer.
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Objective:To explored the mechanism of circ_0009910 in gastric cancer cells by detecting and analyzing the expression of it.Methods:qRT-PCR assay was used to detect the expression level of circ_0009910 in gastric cancer cell lines BGC823, SGC7901, AGS, MGC803 and MKN45. In circumstance, circ_0009910 siRNA was used to knock down circ_0009910 in BGC823 and AGS cells. The transfection efficiency was verified. In BGC823 and AGS cells knocked down by circ_0009910, cell proliferation was detected by MTT assay, colony formation was detected by plate assay, migration and invasion were detected by Transwell, and epithelial-mesenchymal transition (EMT) was detected by western-blotting. The software of SPPSS 18.0 was used to conduct statistical analysis.Results:The relative expression levels of circ_0009910 in BGC823, SGC7901, AGS, MGC803, and MKN45 were (7.238±0.895), (5.023±0.786), (4.184±0.356), (8.561±1.026), (3.478±0.301), which were significantly higher than normal gastric cancer ( P<0.01). After knocking down circ_0009910 by siRNA transfection, the BGC823, AGS cell viability, colony formation number, migration and invasion ability were significantly reduced compared with the control group ( P<0.01), the relative expressions of N-cadherin and Snail proteins were reduced, and E -Cadherin expression increased. Conclusion:Circ_0009910 is highly expressed in gastric cancer cells, and can promote gastric cancer cell proliferation, colony formation, migration, invasion and EMT.
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Objective To study the expression and significance of circ_0009910 in gastric cancer,and evaluate its correlation with clinicopathological characteristics and prognostic value.Methods From Feb.2010 to Nov.2014,there were 129 gastric cancer patients in Beijing Haidian Hospital.One hundred and twenty-nine cases of tumor tissues and 129 paracancerous non-tumor tissues were collected from gastric cancer patients,intraoperatively.The expression of circ_0009910 was detected by qRT-PCR experiment.Then the correlations of circ_0009910 with major clinicopathological characteristics were analyzed.The Kaplan-Meier method was used to analyze overall survival of patients.A Cox proportional hazards regression analysis was used for multivariate analyses of prognostic values.Results The expression level of circ_0009910 in tumor tissues of patients was significantly higher than that in paracancerous non-tumor tissues (P ＜0.01).The expression level of circ_0009910 in patients was significantly associated with clinical stage (P =0.032),distant metastasis (P =0.018) and differentiation (P =0.007),respectively.There was no obvious correlation of the expression level of circ_0009910 with age,gender,Lauren's classification,tumor diameter (P ＞0.05).And the expression level of circ_0009910 was higher in patients with advanced cancer (stage Ⅲ/Ⅳ),distant metastasis and poor differentiation.Survival rate of patients in positive group was significantly lower than negative group (P =0.001 5),with 5-year survival rate were about 29.5％ and 53.2％,respectively.circ_0009910 (P =0.006),distant metastasis (P =0.009) and differentiation (P =0.035) were independent risk factors of overall survival of patients,respectively.Conclusions The expression level of circ_0009910 in tumor tissues of gastric cancer patients was significantly higher than that in paracancerous non-tumor tissues,which was significantly correlated with clinical stage,distant metastasis and differentiation.Survival rate was lower in patients with higher expression level of circ_0009910.circ_0009910 was an independent risk factors of overall survival of patients.
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Objective To evaluate the efficacy and adverse reactions of preoperative intensity-modulated radiotherapy (IMRT) combined with mFOLFOX6 chemotherapy regimen for locally advanced rectal cancer (LARC). Methods A total of 86 patients with LARC who received preoperative IMRT combined with chemotherapy in Shanxi Provincial Cancer Hospital from June 2010 to December 2012 were enrolled. The patients were randomly divided into 2 groups according to the random number table method. Forty-six patients were treated with mFOLFOX6 regimen (mFOLFOX6 group) and 40 patients were treated with fluorouracil (5-Fu) single drug injection (5-Fu group). The total dose of IMRT target region was 45-54 Gy, 25 times in total. Short-term efficacy, adverse reactions, survival and metastasis were evaluated respectively. χ 2test or Fisher test were used to compare the count variable. Kaplan-Meier method was used to calculate the survival rates and Log-rank was used to detect. Results The total follow-up rate was 97.67 % (84/86). There were no statistical differences in the rate of resection (93.5 % vs. 80.0 %), pathological complete remission (pCR) rate (6.5 % vs. 0) and 3-year overall survival (OS) rate (87.0 % vs. 70.0 %) in the mFOLFOX6 group and 5-Fu group respectively (all P ＞ 0.05). Down-staging rate, 3-year disease free survival (DFS) rate and distant metastasis free survival (DMFS) rate in the mFOLFOX6 group were significantly higher than those in 5-Fu group (58.7 % vs. 32.5 %, 79.1 % vs. 50.0 %, 89.1 % vs. 72.5 %, all P ＜0.05). Conclusions Preoperative IMRT combined with mFOLFOX6 regimen can decrease the preoperative staging of LARC patients, improve 3-year DFS rate and DMFS rate. The adverse reactions may increase, but it is tolerant.
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Objective To compare the efficacy and toxicity of paclitaxel and carboplatin regimen concurrent chemoradiotherapy and radiotherapy alone in the treatment of stage Ⅲ cervical cancer.Methods A retrospective analysis of 158 patients with stage Ⅲ cervical cancer who were admitted to Shanxi Provincial Cancer Hospital from May 2009 to October 2012 was conducted.According to different treatment methods,86 patients were in the concurrent chemoradiotherapy group and 72 patients were in the radiotherapy group.The efficacy and adverse reactions of the two groups were compared.Results The effective rate (complete remission + partial remission) in the concurrent radiotherapy group and radiotherapy group was 95.3％ (82/86) and 84.7 ％ (61/72),respectively,and the difference was statistically significant (x2 =5.15,P =0.023).The 1-,2-,3-,and 5-year survival rates of the concurrent radiotherapy group and radiotherapy group were 93.0 ％ (80/86),77.9 ％ (67/86),68.6 ％ (59/86),60.5 ％ (52/86),and 81.9 ％ (59/72),61.1％ (44/72),41.7 ％ (30/72),36.1％ (26/72),respectively,and the differences were statistically significant (x2 values were 4.55,5.29,11.56,9.30,all P ＜ 0.05).The short-term adverse reactions in the concurrent chemoradiotherapy group and radiotherapy group were mainly myelosuppression and gastrointestinal reactions,and the incidence of myelosuppression was 87.2 ％ (75/86) and 50.0 ％ (36/72),respectively,and the difference was statistically significant (x2 =25.96,P ＜ 0.01);the incidence of gastrointestinal reactions was 91.9 ％ (79/86) and 20.8 ％ (15/72),respectively,and the difference was statistically significant (x2 =82.04,P ＜ 0.01).The incidence of radiation proctitis in the concurrent radiotherapy and chemotherapy group was 17.4 ％ (15/86) and 16.7 ％ (12/72),respectively,and the difference was not statistically significant (x2 =0.017,P =0.89);the incidence of radiation cystitis was 7.0 ％ (6/86) and 5.6 ％ (4/72),respectively,and the difference was not statistically significant (x2 =0.134,P =0.71).Conclusion Paclitaxel and carboplatin regimen chemotherapy combined with radiotherapy can improve the survival rate of patients with stage Ⅲ cervical cancer,and the adverse reactions are tolerable.
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Objective To report the clinical features,microsurgical techniques and outcomes of 5 patients admitted in our hospital,who had solid hemangioblastoma in medulla oblongata in the last 5 years.Methods 5 consecutive cases of solid hemangioblastoma in medulla oblongata operated from March,2011 to May,2016 were reviewed and fl lowed up.Results All patients suffered headache,dizziness and cerico-occipital pain from the beginning plus one was found because of obstructive hydrocephalus.The mean duration before operation was 6.7 months.The mean maximum diameter of tumor was (33.7±3.4)mm.The suboccipital posterior midline approach was performed and gross total resection was achieved in all 5 cases.After operation,endotracheal tube was removed in all 5 patients,but 3 received tracheotomy,and all patients can take food freely now through rehabilitation exercise.Followed up until September 2016,all patients lived a normal life.Conclusion The operation of solid hemangioblastoma in medulla oblongata is full of huge risk,but microsurgical resection is the only cure means for the tumor.
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Objective There are differences in the diagnosis and treatment of primary melanocytoma in central nervous sys -tem.The article was to investigate the experience of its diagnosis and treatment . Methods Retrospective analysis were made on the clinical data of 14 cases with primary melanocytoma in central nervous system ( CNS) from January 1999 to December 2012, among which were 5 males and 9 females.The incidence ages were 14-52, average 32.7.The course of disease ranged from half a month to 19 years, geometric average 7.9 months.5 cases recurred and 9 cases occurred first.10 cases were intracranial and 4 were intraspinal. Results 14 patients underwent surgery and had pathologic diagnosis of melanocytoma .Total resection was performed in 7 patients, subtotal resection in 3, and partial resection in 1.Immunohistochemical study showed , in all cases, S-100 and HMB-45 were positive, GFAP and EMA were negative .Vimentin was positive in 8 cases and MelanA positive in 5 cases.12 cases recovered well and dis-charged except for paraplegia and facial paralysis in 1 case each. Conclusion Primary melanocytoma in CNS is very rare .Diagnosis is based on intraoperative findings , surgical pathology and immunohistochemistry results .Surgery is the primary therapy and early total resection is advocated .Adjuvant radiotherapy can reduce the recurrence rate .
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Objective To investigate the clinical effects of partially scar excision, surgical em-bedding and drug releasing in the treatment of small hyperplastic scars. Methods There were 106 pa-tients with small hyperp[astic scars treated by partial excision, released drug injection and adjacent normal skin embedment since May 1995. Results The treatment results were satisfactory. The inci-sions were smooth and uniform after the operations in 106 patients with hyperlastic scars, and there was no consequent scar proliferation according to 1 - 2 years following-up. Conclusions This method is simple and easy to operate. There is reliable blood supply in the embedded skin and no recurrence after the treatment. It is a relatively ideal approach to treat small hyperplastic scars.